On January 23, 1990 Mr. Lou Williams, an optician who specializes in low vision, was convicted by a Montgomery County court of practicing optometry without a license. It was determined that as part of the service at his office in Bethesda, he has been refracting and prescribing glasses for people with low vision who had been referred by nearby ophthalmologists.

Mr. Williams was not fined for the misdemeanor, but was placed on one year's probation and told not to conduct these examinations in the future. He said he would make no comments for this article because he is appealing the decision.

In each state, it is illegal to "refract" or prescribe glasses without a license. However it isn't clear exactly what is considered "refracting." For example, one optometrist involved in this case felt that a person who suggests a telescopic or magnifying aid, based on client's statements of preference, was "refracting" and therefore practicing optometry. It was the opinion of Dr. Hal Glazier, President of the Maryland State Board of Examiners in Optometry, that aids being recommended for use to wear over the eye (including sunglasses and clip-on telescopes), should legally be recommended only by a licensed optometrist or ophthalmologist, but aids which are held in the hand could be recommended by others. An ophthalmologist felt that it would be legal to recommend any aid that can be obtained without a prescription, but what aids require "prescription" for purchase is, again, unclear.

This is an issue about which we should be concerned -- perhaps, if one of our clients has an accident while using sunglasses or another aid recommended by us as an O&M instructor, teacher, or low vision specialist, we may be in the position of having to defend our choice of aids or, worse yet, defend the fact that we were recommending the aid without a license.

Often, legal definitions are determined through court precedents. None of those interviewed, however, were aware of any court cases which could help define what can be legally done without a license.

One of the benefits of AER membership is the ability to network with a variety of professionals. A draft of this article was shared with several of our chapter members, including current President of the Maryland Optometric Association, Dr. Richard Edlow, and Low Vision Specialist Jim Deremeik. They have asked ophthalmologist Dr. Jim Comber, who specializes in low vision, and mobility instructor Dona Sauerburger to join them in trying to clarify the issue of which services require a license, and which can be performed by other professionals. One possibility they are considering is to draft a policy statement which can be agreed upon by the DC-Maryland AER, the Maryland Optometric Association, and the Maryland Society of Eye Physicians. If you have any suggestions, please contact Jim Deremeik at the Maryland School for the Blind (301-444-5000) or Dona Sauerburger (box on page 5).